Cilostazol 100mg tablets

ObjectivesThere is some controversy regarding drug therapy to prevent in-stent restenosis (ISR) after carotid artery stenting. In recent years, cilostazol has received increasing research attention. We performed a meta-analysis to evaluate the effects of cilostazol on the outcome of ISR after carotid stenting.MethodsA meta-analysis was carried out to identify the clinical trials that had been published up to 22 December 2024. The databases PubMed, Embase, Cochrane Library, CNKI and Wanfang have all been queried. The study population was composed of patients with stent carotid heart disease who were receiving cilostazol. Results included in-stent-restenosis, ischemic stroke and all-cause mortality. Publications were reviewed according to the Cochrane Handbook and the guidelines set out in the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA 2020). The methodological quality of the studies was assessed using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I).ResultsThis study was registered with INPLASY (number INPLASY202510004). A total of 1975 patients were included in 4 randomized controlled trials (RCTs) and 5 non-RCTs. A statistically significant reduction in ISR was observed for antiplatelet regimens including cilostazol compared to the control group (OR = 0.27, 95%CI: 0.13 ~ 0.54, P2 = 30%). Subgroup analysis revealed this finding was primarily driven by non-randomized controlled trials (non-RCTs), demonstrating a consistent effect (OR = 0.17, 95%CI: 0.08 ~ 0.39, P2 = 0%). For other primary end events, no significant differences were noted in the incidence of ischemic stroke (OR = 0.83, 95%CI: 0.50 ~ 1.39, P = 0.49, I2 = 0%) or all cause death (OR = 0.53, 95%CI: 0.26 ~ 1.05, P = 0.07, I2 = 0%). The certainty of evidence for the ISR outcome was rated as low.ConclusionsCilostazol was associated with less postoperative carotid stent restenosis, with no statistically significant difference in ischemic stroke and all-cause mortality.

Abstract licence: CC BY-NC-ND

Evidence suggests shared pathophysiologic mechanisms between severe mental illness (SMI) and cardiovascular disease (CVD). Drugs used for CVD, such as antithrombotic agents (ATAs), may therefore be repurposed for the treatment of SMI. We conducted the first systematic review and meta-analysis (PROSPERO registration CRD42024524420) of ATAs for SMI and reported results according to PRISMA guidelines. We searched MEDLINE, Embase, and PsycINFO (October 10, 2024) and performed random-effects meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Primary outcomes were symptom severity, risk of recurrence, and tolerability. We included 12 randomized trials investigating aspirin, cilostazol, and dipyridamole in a total of 742 patients with schizophrenia, major depression, and bipolar disorder. Results showed that ATA treatment may reduce depressive symptoms in patients with SMI (SMD -0.62; 95 % CI -1.11 to -0.13; 8 studies; very low-certainty evidence). Based on studies with low risk of bias, ATA treatment may reduce PANSS total score compared with placebo (SMD -0.57; 95 % CI -0.86 to -0.28; 3 studies; very low-certainty evidence). Tolerability of ATAs may not differ from placebo (RR 0.89; 95 % CI 0.57-1.40; 9 studies; very low-certainty evidence). Given the low certainty of the evidence, effect estimates should be interpreted with caution. The therapeutic potential of ATAs in SMI remains uncertain. Well-powered RCTs investigating clinically relevant outcomes in clearly defined populations are needed.

Abstract licence: CC BY-NC-ND